The present disclosure relates to surgical instrumentation. While the present disclosure is made in the context of femoroacetabular impingement (FAI) surgery of the hip, it is understood that the principles herein may be applicable in other tissue removal applications, whether arthroscopic, laparoscopic, endoscopic, or open, including but not limited to: foot, knee, hip, pelvis, spine, ribs, shoulder, elbow, wrist, hand, craniomaxillofacial, etc.
Straight, rigid tissue cutting instruments are not well suited to creating a smooth anatomic radius of curvature with minimal manipulation. With these tools, it is up to the surgeon to attempt to sculpt a three-dimensional (3D) anatomic surface by precisely manipulating the cutter over the treated surface, without accidentally removing too much tissue. This requires great skill, practice, patience and time.
It is desirable to provide a more efficient means of tissue removal, including removal of sclerotic bone, in order to reduce operating time. The disclosed examples are capable of removing tissue on multiple curved surfaces at once, creating a smooth uniform surface with minimal manipulation of the cutting tip. The instruments described herein may automatically re-establish a proper anatomic curvature to the treated surface by matching the natural anatomic curvature of the tissue. The instruments described herein are capable of producing 3D shaping with simple two-dimensional (2D) manipulation of the instruments. The instruments and methods described herein may significantly reduce operating time and produce more uniform results.
In one embodiment of the present technology, the tissue resection device includes a hollow member with a window formed therein, a drive member, and a rotary cutting member having a concave or hourglass shape that is at least partially exposed from the outer housing. The hourglass shaped cutting element may be curved to approximately match the geometry of the tissue to be resected. The device may also be fitted with a protective hood, or sheath with at least one cutout or window through which the cutting element or burr may be exposed. The window may be sized and shaped to vary the amount of burr exposure through the window to control the amount and/or depth of tissue that is removed in a single pass of the instrument. In this manner, the size and shape of the window may act as a “depth stop” to provide extra control and precision over tissue removal and prevent accidental or excessive tissue removal. The depth stop window may be sized and shaped to achieve a substantially uniform cut depth along the curved burr portion of the resection device. The window in the outer sheath may be sized and shaped to allow the burr to project a predetermined amount from the window to limit the amount of tissue removed in a single pass. Moreover, the window in the outer sheath may be sized and shaped to track the curvature of the burr such that the burr projects uniformly from the window along the length of the curved burr to achieve a substantially uniform depth cut at each point along the length of the curved burr. The protective hood may also be rotatable or translatable to selectively cover all or a portion of the burr. The protective hood and/or hollow member may be made of transparent material.
In some embodiments, the user may selectively adjust how much the burr projects from the window. In this manner, the user may control the depth of the tissue cut in a single pass to allow for quick tissue resection or for slower, more “finely-tuned”, tissue resection.